Hepaguşlar H, Ozzeybek D, Elar Z
Department of Anaesthesiology, Ege University Hospital, Izmir, Turkey.
Anaesthesia. 1999 Jun;54(6):593-6. doi: 10.1046/j.1365-2044.1999.00799.x.
Patients with cerebral palsy who are treated with anticonvulsant medication are resistant to vecuronium. We examined the contributions to vecuronium resistance made by cerebral palsy and anticonvulsants in a study of children with cerebral palsy and a control group. The acceleromyographic responses of the following three groups of children were studied: children with cerebral palsy not taking anticonvulsant medication (n = 11); children with cerebral palsy taking anticonvulsant medication (n = 8); and a control group of children who did not have cerebral palsy and were not taking anticonvulsant treatment (n = 10). Using a standardised technique, general anaesthesia was induced and maintained with 0.5-1. 5% isoflurane in a 60/40 nitrous oxide in oxygen mixture. After a stabilisation period which was performed with supramaximal train-of-four stimuli (2 Hz every 15 s) an intubating dose of vecuronium 0.1 mgkg-1 was administered. The first twitch of the train-of-four response (T1), the onset time, the times to 25, 50, 75 and 90% recovery of T1, recovery index, and the time to 70% recovery of train-of-four ratio were recorded. Recovery times to T1 and train-of-four responses were reduced significantly in both groups of children with cerebral palsy compared with the control group. These results suggest that children with cerebral palsy display resistance to vecuronium whether or not they are taking anticonvulsant drugs.
接受抗惊厥药物治疗的脑瘫患者对维库溴铵耐药。我们在一项针对脑瘫儿童及对照组的研究中，考察了脑瘫和抗惊厥药物对维库溴铵耐药性的影响。研究了以下三组儿童的加速度肌电图反应：未服用抗惊厥药物的脑瘫儿童（n = 11）；服用抗惊厥药物的脑瘫儿童（n = 8）；以及未患脑瘫且未接受抗惊厥治疗的对照组儿童（n = 10）。采用标准化技术，以0.5 - 1.5%异氟醚在60/40氧化亚氮 - 氧气混合气体中诱导并维持全身麻醉。在使用超强四个成串刺激（每15秒2赫兹）进行稳定期后，给予维库溴铵插管剂量0.1毫克/千克。记录四个成串反应的第一个抽搐（T1）、起效时间、T1恢复到25%、50%、75%和90%的时间、恢复指数以及四个成串比值恢复到70%的时间。与对照组相比，两组脑瘫儿童T1和四个成串反应的恢复时间均显著缩短。这些结果表明，无论是否服用抗惊厥药物，脑瘫儿童均表现出对维库溴铵的耐药性。
